World AIDS Day: Study shows access to testing and care lags in U.S.

Rick Rycroft / AP FIREWORKS BURST over the Sydney Opera House Wednesday in Sydney, Australia. The opera house is bathed in red light as part of a global campaign to create an AIDS-free generation by 2015. Over 50 landmarks and iconic monuments around the world will turn red today in support.

The United States has long been at the center of the acquired immune deficiency disease epidemic. AIDS was first identified here in 1981. Many of its treatments were devised here. Leadership and funding for the global fight against AIDS comes from here.

So it is more than ironic that on this World AIDS Day, new statistics show huge gaps in diagnosis and treatment here.

The Centers for Disease Control and Prevention estimates there are 1.2 million people living with the human immunodeficiency virus, the virus that causes AIDS, in the United States. As many as 240,000 of them — one in five — don’t even know they have HIV because they have not been tested.

Antiretroviral therapies are proven to reduce the amount of virus in a patient’s body, yet only half of Americans with HIV are getting this treatment, according to CDC. Consequently, only 28 percent of people with HIV have their virus under control.

We also know how HIV is transmitted from one person to another — through unprotected sex, sharing intravenous needles and from mothers to their newborns — and therefore we know how to prevent infection. Counseling patients on how to protect themselves and others from HIV infection is effective, but CDC says less than half of people who are being treated for HIV received such counseling in the previous year.

What can you do?

For one, get tested for HIV. The CDC recommends all Americans between the ages of 13 and 64 be tested for HIV at least once as part of their routine health checkups. People at greater risk — those with multiple sex partners, people who inject drugs or men who have sex with other men — should get tested at least once a year. By knowing your HIV status, you can take steps to prevent transmission of the virus and get into treatment.

The CDC statistics also point to a greater need for doctors and public health departments get patients tested, and for those testing positive, steering them toward treatment and prevention counseling. This is an even bigger challenge in an era of high unemployment, vanishing health benefits and a shrinking safety net.

Even with these gaps, the situation in the United States is orders of magnitude better than in other parts of the world. According to the World Health Organization, more than half of the people who need antiretroviral therapy in low- and middle-income countries don’t have access to it.

Even so, the tide is turning in the global fight against AIDS. WHO says access to HIV services resulted in 15 percent fewer new infections over the past 10 years and a 22 percent decline in AIDS-related deaths in the past five years.

Science also is providing glimmers of hope. Drug therapies allow many people to manage AIDS as a chronic disease. Researchers also are working on a cure — something thought to be unattainable not that long ago. There have been a couple of small, but promising, successes using bone marrow transplants and gene therapy.

The world’s response to AIDS has come a long way since 1981. It still has many miles to go.